Assessment of cerebrovascular insufficiency with MR-ASL perfusion in patients with moyamoya angiopathy

Purpose. To develop a methodology for assessing the degree of cerebrovascular insufficiency in patients with moyamoya angiopathy (AMM) based on measurement cerebral blood flow (CBF) and determination presence arterial transit artifact (ATA) using MR method spin labeling (ASL). Materials methods. The study included 47 AMM who underwent 148 studies PCASL mode (296 hemispheres), which (94 hemispheres) were done before surgical treatment. On received perfusion maps 7 areas interest (ROI) manually set gray white matter brain “Fusion” technique outside ATA zones. CBF values at central point estimated. In preoperative stage, direct angiography to assess stage disease according Suzuki, severity leptomeningeal transdural collaterals Houkin level ICA stenosis. Statistical processing univariate analysis variance (ANOVA) chi-square test (IBM SPSS Statistics 23). Results. was detected 77% (69% hemispheres). average minimum 120.2 ± 21.1 ml/min/ 100 g lower bound confidence interval 117.43 ml/min / g. maximum 234.9. Depending MCA territory ATA, 4 degrees deficiency identified: 0 (CBF = 64.5 16.2 g, without ATA) corresponded “compensation” flow, 1 61.5 16.6 – “subcompensation”, 2 26.5 7.2 ml/min/100 “initial decompensation”, 3 16.0 4.7 “decompensation”. highlighted statistically significantly differed among themselves all ROIs (p < 0.0001). More severe more developed stages Suzuki Houkin, proximal stenosis 0.0001), neurological deficit 0.02). occurrence reliably reflected 0.001). Conclusions. proposed patterns ASL has good agreement disease, sources collateral circulation, can be used AMM.